A defiant Rick Perry defended his decision to reject the expansion of Medicaid on Monday, saying on Fox News Channel that the federal government couldn't be trusted and that “we’re just not going to part of socializing healthcare in the state of Texas.”

“People need to be free to make those decisions about their healthcare and not be forced by this administration into these exchanges or into bankrupting states with the expansion of Medicaid,” he said.

The Texas governor blasted Medicaid as a “failed program” and likened expansion of it to “adding 1,000 people to the Titanic.” He cast his decision as an effort to protect Texans' ability to choose their coverage, but also as a push to stop the country, and state, from adding debt.

Asked why he would turn down billions of dollars in federal money to set up the expansion, Perry questioned how that would help American get “back on track economically.”

“I’m always intrigued by the concept that there’s free money out there,” he said. “That we can pour more money into a program that is already failed and somehow or another we’re going to have a different result.”

Perry offered block granting money to the states as an alternative, so healthcare decisions could be made at the state and local level. He said that “every Texan has healthcare in this state from the standpoint of being able to have access to it” and that state officials are better positioned to make policy decisions than “some bureaucrat in Washington”

The governor added that there are still unresolved details about the healthcare exchanges and that he wasn't ready to take the Obama administration in good faith.

“Well, we don’t trust this administration,” he said. “And we don’t trust Washington, D.C., to be able to deliver healthcare in our states. We would do a substantially better job than what you would see with these exchanges and with the expansion of Medicaid.”

“The idea that this federal government, which doesn’t like Texas to begin with, can pick and choose and come up with some data to say Texas has the worst healthcare system in the world is just fake and false on its face,” he said.

Update at 10:56 a.m.:Here's an update from Staff Writer Tom Benning.

The Texas Democratic Party has released a statement from spokeswoman Rebecca Acuña calling Perry's decision “both cruel and negligent.”

“Rick Perry’s announcement is both cruel and negligent. No person with a speck of intelligence would turn down billions in federal dollars that would be a boon to our economy and help Texans. But then again this is Rick Perry. Rick Perry could’ve brought billions in federal dollars to Texas, reduced the rate of the uninsured and improved the quality of life for Texans. Rick Perry’s Texas solution is to let Texans stay ill and uninsured. That is not a health care plan. Once again Perry is putting partisan political pandering in front of the interests of Texas.”

Update at 10:02 a.m.:Here's an update from Staff Writer Robert T. Garrett in Austin.

Straus opposes the federal health law, and said he hopes Republicans will recapture the White House and Senate, and repeal it. If the law stands, however, Straus said the Legislature “will be much more involved in the decision making on this.”

But he said of Perry, “I have no quarrel with his approach today.”

Straus, who spoke to reporters after he testified before a House panel about state dedicated taxes, criticized the proposed Medicaid expansion as “a big, massive federal increase, … another entitlement,” that he said is unwise, “especially in these fiscal times.”

He predicted that adding more than 1.5 million uninsured adults to the state's Medicaid rolls wouldn't work as anticipated. Too few doctors are willing to accept new Medicaid patients, Straus noted, citing a new survey by the Texas Medical Association.

“The federal government can't handle what they say they can handle,” Straus said. “Just because you wave a wand in Washington doesn't mean you've solved a problem.”

Original post: We ran a piece a few days back that began: “Gov. Rick Perry won’t say whether Texas should take or reject the federal largesse that could allow the state’s Medicaid program to cover more poor adults.”

That was then. This is now: Shocking no one, Perry said in a release this morning that no way, no how would he expand Medicaid.

“If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare,” says the governor. “I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government.”

He dispatched a missive to U.S. Health and Human Services Secretary Kathleen Sebelius underscoring that point. As in:

In the ObamaCare plan, the federal government sought to force the states to expand their Medicaid programs by — in the words of the Supreme Court — putting a gun to their heads. Now that the “gun to the head” has been removed, please relay this message to the President: I oppose both the expansion of Medicaid as provided in the Patient Protection and Affordable Care Act and the creation of a so-called “state” insurance exchange, because both represent brazen
intrusions into the sovereignty of our state.

As The News has reported before, the stakes of this decision are huge. Texas has 6.1 million uninsured people. These folks obviously consume health care services, so their health costs get distributed across other populations: hospitals, insured consumers (who pay higher insurance premiums, to make up for the costs of the uninsured) and local taxpayers (who fund county hospitals that treat the uninsured).

To be sure, Texas faces some additional costs if it expands Medicaid. The state's health and human services commission estimates its minimum new costs at $9.5 billion over 10 years. But the state would receive $112 billion in federal money to implement the Medicaid expansion.

With a few exceptions, Texas health care companies and other businesses favor the insurance expansion. Hospitals want to see more paying customers, even if Medicaid is paying. Small businesses want a decent option for covering their employees (to wit, the health insurance exchanges, where people can use tax credits to offset the cost of insurance).

Perry has set himself up for a major policy fight in the 2013 session of the Texas Legislature, as well as another battle with the Obama administration and Washington.